Wednesday, 3 January 2018

7 Treatments And Diagnosis For Sjogren's Disease (Sjogren's Syndrome)

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Sjogren's syndrome can be difficult to diagnose because the signs and symptoms vary from person to person and can be similar to those caused by other diseases. Side effects of a number of medications also mimic some signs and symptoms of Sjogren's syndrome. Tests can help rule out other conditions and help pinpoint a diagnosis of Sjogren's syndrome.

Diagnosis

The diagnosis of Sjögren's syndrome involves noting criterion such as dryness of the eyes and mouth. Significant dryness of the eyes can be determined in the doctor's office by testing the eye's ability to wet a small testing paper strip placed under the eyelid  (Schirmer's test using Schirmer tear test strips). More sophisticated testing can be done by an eye specialist (ophthalmologist). This disease can be diagnosed using any of the methods below -

  • Blood tests: Sjögren's triggers the presence of special antibodies in the blood. As these antibodies only show up in about 60 to 70 percent of people with Sjögren's, a negative result does not mean the syndrome can be ruled out. This frequently causes confusion in initial diagnosis.
  •  Eye tests : Your doctor can measure the dryness of your eyes with a test called a Schirmer tear test. A small piece of filter paper is placed under your lower eyelid to measure your tear production. A doctor specializing in the treatment of eye disorders (ophthalmologist) might also examine the surface of your eyes with a magnifying device called a slit lamp. He or she may place drops in your eye that make it easier to see damage to your cornea. 
  • Chest X-ray or CT-scan : This determines the presence of inflammation in the lungs, which can be caused by Sjögren's 
  •  Salivary scintigraphy. This nuclear medicine test involves the injection into a vein of a radioactive isotope, which is tracked over an hour to see how quickly it arrives in all your salivary glands. 
  •  Ophthalmological tests: An ophthalmologist can carry out the Rose Bengal, Lissamine green, and Schirmer eye tests. Dyes and blotting paper are used to expose dry areas on the eye.
  • Urine testing: Urine is sampled and tested to determine whether the kidneys have been affected


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Treatments For Sjogren's Disease

The treatment of patients with Sjögren's syndrome is directed toward the particular areas of the body that are involved and prevention of complications such as infection. There is no cure for Sjögren's syndrome. Dryness of the eyes can be helped by artificial tears, using eye-lubricant ointments at night, and minimizing the use of hair dryers. When dryness becomes more significant, the ophthalmologist can plug the tear duct closed so that tears cover the eye longer.

  1. Artificial saliva : Saliva substitutes and mouth-coating gels can relieve dryness of the mouth. They are available as sprays, pre-treated swabs, and liquids. These can be important at night, as the mouth becomes dryer during sleep. 
  2.  Eye drops : Prescription eyedrops such as cyclosporine (Restasis) or lifitegrast (Xiidra) may be recommended by your eye doctor if you have moderate to severe dry eyes.
  3.   Nonsteroidal anti-inflammatory drugs (NSAIDs) : Anti-inflammatory drugs such as aspirin , naproxen, and ibuprofen can provide relief for people with Sjögren's who are experiencing joint pain.
  4.  Artificial tears : Artificial tears can help to lubricate the eyes, and are available over-the-counter (OTC). Prescription options are available that reduce the need for artificial tears, such as cyclosporine ophthalmic emulsion and hydroxypropyl cellulose pellets 
  5.  Surgery : A minor procedure to seal the tear ducts that drain tears from your eyes (punctal occlusion) might help relieve your dry eyes. Collagen or silicone plugs are inserted into the ducts to help preserve your tears. 
  6. Disease-modifying antirheumatic drugs (DMARDs) : In cases where the joint pain is accompanied by fatigue and rashes, DMARDs may relieve symptoms. Examples include hydroxychloroquine or methotrexate. If Sjögren's seems to be affecting the muscles, nerves, lungs, or kidneys, stronger DMARDs or corticosteroids may be prescribed. 
  7.  Increase your fluid intake : Take sips of fluids, particularly water, throughout the day. Avoid drinking coffee or alcohol since they can worsen dry mouth symptoms. Also avoid acidic beverages such as colas and some sports drinks because the acid can harm the enamel of your teeth.
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Dietary addition of flaxseed oil may also benefit eye dryness. Vitamin D supplementation may be beneficial, especially in those who have insufficient vitamin D blood levels. The dry mouth can be helped by drinking plenty of fluids, humidifying air, and good dental care to avoid dental decay. The glands can be stimulated to produce saliva by sucking on sugarless lemon drops or glycerin swabs.



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Author: Richard Smith